First Case of COVID-19-Associated Collapsing Glomerulopathy in Sub-Saharan Africa

Nlandu, Yannick Mayamba; Makulo, J.R.; Pakasa, Nestor M; Sumaili, Ernest Kiswaya; Nkondi, C.; Bukabau, Justine Busanga; Beya, François K.; Nseka, Nazaire Mangani; Lepira, François Bompeka; Bergner, Raoul

doi:10.1155/2020/8820713

Cited by 18 publications

(26 citation statements)

References 23 publications

(32 reference statements)

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“…Case reports, small case series, and autopsy studies have shown a wide spectrum of kidney manifestations in COVID-19 patients and have improved our understanding of kidney disease in this population. Reported manifestations in native biopsies include acute tubular injury (ATI) 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , myoglobin cast nephropathy 7 , thrombotic microangiopathy (TMA) 9 , 16 , 20 , 25 , 26 , 27 ; acute interstitial nephritis 14 , 28 , non-collapsing focal and segmental glomerulosclerosis (FSGS) 9 , 19 , 20 , 29 , collapsing glomerulopathy (also known as COVID-19 associated nephropathy, COVAN) 7 , 8 , 9 , 15 , 20 , 21 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , membranous nephropathy 8 , 20 , 42 , minimal change disease 48 , 49 , 50 , 48 , 49 , 50 , 48 , …”

Section: Introductionmentioning

confidence: 99%

A multi-center retrospective cohort study defines the spectrum of kidney pathology in Coronavirus 2019 Disease (COVID-19)

May

Cassol

Hannoudi

et al. 2021

Kidney International

108

139

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Kidney failure is common in patients with Coronavirus Disease-19 (COVID-19) resulting in increased morbidity and mortality. In an international collaboration, 284 kidney biopsies were evaluated to improve understanding of kidney disease in COVID-19. Diagnoses were compared to five years of 63,575 native biopsies prior to the pandemic and 13,955 allograft biopsies to identify diseases increased in patients with COVID-19. Genotyping for APOL1 G1 and G2 alleles was performed in 107 African American and Hispanic patients. Immunohistochemistry for SARS-CoV-2 was utilized to assess direct viral infection in 273 cases along with clinical information at the time of biopsy. The leading indication for native biopsy was acute kidney injury (45.4%), followed by proteinuria with or without concurrent acute kidney injury (42.6%). There were more African American patients (44.6%) than patients of other ethnicities. The most common diagnosis in native biopsies was collapsing glomerulopathy (25.8%) which associated with high-risk APOL1 genotypes in 91.7% of cases. Compared to the five-year biopsy database, the frequency of myoglobin cast nephropathy and proliferative glomerulonephritis with monoclonal IgG deposits was also increased in patients with COVID-19 (3.3% and 1.7%, respectively), while there was a reduced frequency of chronic conditions (including diabetes mellitus, IgA nephropathy, and arterionephrosclerosis) as the primary diagnosis. In transplants, the leading indication was acute kidney injury (86.4%), for which rejection was the predominant diagnosis (61.4%). Direct SARS-CoV-2 viral infection was not identified. Thus, our multi-center large case series identified kidney diseases that disproportionately affect patients with COVID-19, demonstrated a high frequency of APOL1 high-risk genotypes within this group, with no evidence of direct viral infection within the kidney.

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Section: Introductionmentioning

confidence: 99%

A multi-center retrospective cohort study defines the spectrum of kidney pathology in Coronavirus 2019 Disease (COVID-19)

May

Cassol

Hannoudi

et al. 2021

Kidney International

108

139

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“…Direct viral podocyte invasion is supported by electron microscopy findings of coronavirus particles within the cytoplasm of podocytes in native and post-mortem biopsies. Suggestions of CG secondary to cytokine release from systemic COVID-19 manifestations have been proposed, particularly in those with APOL1 high risk genotype and African-Caribbean ethnicity[ 13 - 22 , 24 - 29 ]. Basic-science studies have shown viral infections stimulating interferon production which in turn encourages APOL1 gene expression[ 74 ].…”

Section: Discussionmentioning

confidence: 99%

Native and transplant kidney histopathological manifestations in association with COVID-19 infection: A systematic review

Jeyalan¹,

Storrar²,

Wu³

et al. 2021

WJT

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BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can result in clinically significant multi-system disease including involvement in the kidney. The underlying histopathological processes were unknown at the start of the pandemic. As case reports and series have been published describing the underlying renal histopathology from kidney biopsies, we have started to gain an insight into the renal manifestations of this novel disease. AIM To provide an overview of the current literature on the renal histopathological features and mechanistic insights described in association with coronavirus disease 2019 (COVID-19) infection. METHODS A systematic review was performed by conducting a literature search in the following websites-‘PubMed’, ‘Web of Science’, ‘Embase’ and ‘Medline-ProQuest’ with the following search terms-“COVID-19 AND kidney biopsy”, “COVID-19 AND renal biopsy”, “SARS-CoV-2 AND kidney biopsy” and “SARS-CoV-2 AND renal biopsy”. We have included published data up until February 15, 2021, which includes kidney biopsies (native, transplant and postmortem) from patients with COVID-19. Data on clinical presentation, histopathological features, management and outcome was extracted from the reported studies. RESULTS The total number of biopsies reported on here is 288, of which 189 are postmortem, 84 native and 15 transplants. The results are varied and show underlying pathologies ranging from collapsing glomerulopathy and acute tubular injury (ATI) to anti-nuclear cytoplasmic antibody associated vasculitis and pigment nephropathy. There was variation in the specific treatment used for the various renal conditions, which included steroids, hydroxychloroquine, eculizumab, convalescent plasma, rituximab, anakinra, cyclophosphamide and renal replacement therapy, amongst others. The pathological process which occurs in the kidney following COVID-19 infection and leads to the described biopsy findings has been hypothesized in some conditions but not others (for example, sepsis related hypoperfusion for ATI). It is important to note that this represents a very small minority of the total number of cases of COVID-19 related kidney disease, and as such there may be inherent selection bias in the results described. Further work will be required to determine the pathogenetic link, if any, between COVID-19 and the other renal pathologies. CONCLUSION This report has clinical relevance as certain renal pathologies have specific management, with the implication that kidney biopsy in the setting of renal disease and COVID-19 should be an early consideration, dependent upon the clinical presentation.

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“…Several biopsy studies of kidneys which suffered from collapsing glomerulonephritis, now being called COVAN, had APOL1 gene [25] Collapsing Glomerulonephritis was not documented in any of the SARS-CoV-2 outbreaks that happened in the European and Chinese population probably because these population lack APOL1 genotype [26]. APOL1 gene is also a risk factor for endstage kidney disease associated with hypertension [27]. Two high risk alleles of the gene was documented in a 65-year-old Afro-American male patient of covid-19 in a study, viz., APOL1 G 1 and APOL1 G 2 .…”

Section: Role Of Apol1 Genementioning

confidence: 99%

“…In podocytes, the gene mediates the activation of viral activity. This dysregulates the functions of the cell organelles causing great damages to the podocytes [27][28][29][30][31][32][33][34][35].…”

Section: Role Of Apol1 Genementioning

confidence: 99%

Pathways of Renal Involvement in COVID-19 Infection

Ouseph

Patil

2021

JPRI

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The causative agent of the highly infectious pandemic COVID-19 is SARS-CoV-2. According to WHO, as of August 18th 2020, the number of confirmed cases was and confirmed deaths was 771,635 from 216 countries. The most affected organ system in COVID-19 is the respiratory system. Later studies proved that the virus caused multiorgan infections. Several studies shows that SARS-CoV-2 causes damage to the renal system and; critically ill patients with associated renal damage show a higher mortality rate as compared to those patients with an unaffected renal system .This review article aims at updating the knowledge about associated kidney failure in covid-19 cases and its impact on the morbidity and mortality. The virus damages the renal system through two different mechanisms: Direct and Indirect pathway. The direct pathway explains how the virus damages the renal system by directly acting upon the target cells in the kidney.SARS-CoV-2 gains its entry by binding to the ACE2 receptors on the target cell. The SARS-CoV-2 progresses its journey and extensively spread the infection, damaging the kidneys leading to the failure of the renal system. The indirect pathway of damage speaks about the secondary damage caused to the renal system due to cytokine release syndrome caused by SARS-CoV-2.This pathway also points out the formation of microthrombi in the glomerular capillaries and also kidney hypoperfusion. AKI in covid-19 patients can occur secondary to multiorgan failure. This review aims to build a foundation concerning the direct pathway and indirect pathway by means of which SARS-Cov-2 infects the kidneys by summarizing the numerous researches carried out till date to update the knowledge gained thus far to aid in building better protocols for covid-19 management and decrease morbidity caused due to renal damage.

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First Case of COVID-19-Associated Collapsing Glomerulopathy in Sub-Saharan Africa

Cited by 18 publications

References 23 publications

A multi-center retrospective cohort study defines the spectrum of kidney pathology in Coronavirus 2019 Disease (COVID-19)

A multi-center retrospective cohort study defines the spectrum of kidney pathology in Coronavirus 2019 Disease (COVID-19)

Native and transplant kidney histopathological manifestations in association with COVID-19 infection: A systematic review

Pathways of Renal Involvement in COVID-19 Infection

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